Provider Demographics
NPI:1154304665
Name:MONEYPENNY, JAMES R (PHD PA)
Entity Type:Individual
Prefix:
First Name:JAMES
Middle Name:R
Last Name:MONEYPENNY
Suffix:
Gender:M
Credentials:PHD PA
Other - Prefix:
Other - First Name:JAMES
Other - Middle Name:R
Other - Last Name:MONEYPENNY
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:PHD PA
Mailing Address - Street 1:8500 W MARKHAM ST
Mailing Address - Street 2:STE 305
Mailing Address - City:LITTLE ROCK
Mailing Address - State:AR
Mailing Address - Zip Code:72205-2453
Mailing Address - Country:US
Mailing Address - Phone:501-227-7044
Mailing Address - Fax:501-227-7259
Practice Address - Street 1:8500 W MARKHAM ST
Practice Address - Street 2:STE 305
Practice Address - City:LITTLE ROCK
Practice Address - State:AR
Practice Address - Zip Code:72205-2453
Practice Address - Country:US
Practice Address - Phone:501-227-7044
Practice Address - Fax:501-227-7259
Is Sole Proprietor?:No
Enumeration Date:2005-11-29
Last Update Date:2013-04-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ARAR 82-15P103G00000X, 103TB0200X, 103TC0700X, 103TC1900X, 103TF0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC1900XBehavioral Health & Social Service ProvidersPsychologistCounseling
No103G00000XBehavioral Health & Social Service ProvidersClinical Neuropsychologist
No103TB0200XBehavioral Health & Social Service ProvidersPsychologistCognitive & Behavioral
No103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical
No103TF0200XBehavioral Health & Social Service ProvidersPsychologistForensic
Provider Identifiers
StateIdentifier IDID TypeIssuer
AR105182719Medicaid
AR56310OtherBLUE CROSS BLUE SHIELD
AR56310Medicare ID - Type Unspecified